With the end of daylight savings time (DST) just around the corner – Sunday, Nov. 4 at 2 a.m. – healthcare IT departments are springing forward to prepare for the clocks to fall back. An annoyance for some is a mission- and life-critical event for healthcare providers around the country.
"If clinical decisions are being made on data that isn’t accurate in terms of the timing of when it was taken and a patient dies, then there can be a lot of liability issues that come in to play as the documentation will be called in to question." says Rob Jennings, of Capsule Tech, a device integration company, naming just the most serious consequence of failing to prepare for the clock switchover.
Jennings says transitioning from daylight savings back to normal time has long been a subject worthy of caution. "The whole scare that was Y2K was a bust from an IT perspective." he says, venturing that the healthcare IT industry "probably [has] more issues on a yearly basis with DST changes."
From timestamp errors that can result in data loss to decisions being based on faulty records, staying on top of DST is a must-do for any healthcare IT department. Some things to think about this weekend:
1. Shutting off data output feed. Devices that are integrated with an EHR attach a timestamp to the data they send in to the main system. This allows care providers know when data was collected, and helps them to make decisions based on that. However, when the clocks roll back, so do the timestamps. If a provider isn't ready for this, the discrepancy in timestamps could confuse providers or lead to data being overwritten and lost. In order to be prepared for DST, Jennings says, the first step is to make sure devices aren't sending out data to an EHR system that will cause inconsistencies with its timestamps. The simplest way to do this is to shut off the data output feed of the devices. Jennings says this is a critical action to take because "we want to avoid getting vital sign data out of sync."
2. Backup. "Usually this does happen on a regular basis," says Jennings of data backups. He notes though that with larger systems, "Backups are scattered and scheduling is skewed to spread loads on systems." Additionally, the type of backup needs to be considered: Is data being sent to the cloud, or copied on to tape and sent to offsite storage? It is critical to "get all of your backups done and get them complete in case there is any situation that comes up," he says. Being ready for a DST rollover means making sure that all backups have been completed ahead of the time change, and that any regularly scheduled backups that take place during the time change are paused. "Most systems will be backing up between midnight and 5 a.m.," he adds. "But I don't think you want to be backing up between [those times]," because of timestamp inconsistency.
3. Manual charting. Clocks aren't the only things being rolled back during DST: The calendar goes back a few pages too, as Jennings says care providers will be scrambling to manually chart all of the things that integrated devices would be sending to an EMR. And it's not just heart rate or blood pressure. "We have a lot of devices that are wandering around an institution [such as ventilators and fusion pumps] that are integrated [electronically to an EMR] but might not be time synched," he says. All of the data that would normally be sent automatically to a system needs to be recorded by hand during the rollover. Jennings notes that because DST happens every year, this shouldn't be too much of an issue for healthcare providers.